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David pham 63540197 Writing 39C Proposal Paper 3 June 1999 Who Wins With ERISA The system of managed care began in the United States in the early 1900s in an effort to provide coordinated health care in a cost-effective wayAmer Assoc of Retired Persons Until recently managed care has emerged from the shadows to become the dominant form of health insurance and delivery succeeding the older fee-for-service program Zelman and Berenson 2 Today about 160 million Americans are enrolled in some kind of managed care plan Managed care has made health care more affordable andmore accessible for Americans But sometimes cost cutting can lead to lower standards Clinton 1 Because managed care plans provide medical care to their members at a fixed rate there is a substantial limit to the medical care each member can receive Under this system of prepayment managed care organizations MCOs can profit off every dollar of revenue that is not directly spent on patient care This produces the problem of incentives or temptations for MCOs not to provide sufficient medical care to their members all too often resulting in tragedy Fox et al 56 This problem explicitly impacts the estimated 125 million Americans who receive health insurance through MCOs that are provided by their employers A federal law known as the Employment Retirement Income Security Act of 1974 ERISA governs these self-insured plans Under the Employment Retirement Income Security Act ERISA-regulated MCOs are not legally held accountable for their actions Until Congress passes The Patients Bill of Rights MCOs will continually and wrongfully deny patients from quality care Health costs have continually risen over the last decade The average-income American family now spends an estimated 5000 per year on health care alone an amount that more than doubled from 1988-1996 Maciejewski In an effort to relieve working Americans from this burden Congress devised a federal tax law that would enable employees to obtain tax benefits for health insurance through their
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